Effin Healthcare

[dollyjn]

I am a healthcare consumer just like you. I have offered up the process to you.
Don't shoot the messenger.

[clif]

being a consumer doesn't preclude you from being a lawyer or insurance broker or insurance related business. you're already displaying a disability in being honest.
why not answer the question?
and, i was responsible, i had insurance, comprehensive, no limit. by choice and contractual agreement.

you imply that i did no understand the process. well, a genius plan by the corporations as well. make the process impenetrable, then blame the victim.

then, be vague and elusive.

of course, in a cosmetic world of superficial PR, all surgery would be selective and discretionary.

come on dolly, you posing as a disinterested citizen??

[dollyjn]

I am not a saleperson or lawyer. sheesh

[dollyjn]

Just because someone understands the business does not make them IN the business. duh

[dollyjn]

The information provided is clear and concise and there are people in place to answer questions. The PROBLEM is that people DO NOT ask questions. They take for granted everything will be taken care of. Not so, obviously...

[clif]

rest easy, i'm not saying you understand. i'm glad that all your interactions/experiences with health insurance providers has left you with such a favorable impression.

'clear and concise and answer questions'. who are you referring to? - all insurance companies?

wiggle and squrim. def. a good route name.

[dollyjn]

If you were 'listening', I am a customer of the health insurance and health system world as you.
Good Luck

[dollyjn]

My health insurance does not cover everything and I have to pay just as everyone else does. It's not that I am for or against.
The process is the process and accepting it, learning it and making it work to the best outcome FOR me is in my favor.
I advise anyone to do the same. There is no accusation intended here.

[Rotarypwr345704]

Clif, as someone who works in a doctors office and gets precerts daily, here is what really happens. Let's say for easy math's sake, your bill is $100. Your insurance company has decided that it should only cost $60, they cover 80% (this percentage varies based on company but is pretty close) which is $48 dollars and you are responsible for the other $12 do cover the $60. Period. That's the law. The insurance companies truly decide what they are going to pay, pay 80% and you are left with the other 20%. Now.
Since you claim you had a bill for ~70,000 dollars, something is obviously wrong. First thing you should do is ask for an itemized statment (you are legally entitled to one, in case they refuse). With this step alone you'd be surprised how quickly your bill will go down. Next step is to get someone to review the pre-cert. As healthcare providers, when we bill for something there is a medical code called an ICD-9. This code is what determines your eligibility for EVERYTHING. We get these codes from a book that is over 1500 pages. And for some insurance companies you have to use just the right code in order for them to pay. So you can see where the margin of error could JUST be off... If you have a huge, unexpected bill you need someone to get a retrocertification. I do these all the time and get these expenses covered.
You should try these things. But what I'm worried about is if you've already started to pay on it. If you've started to pay, it may be too late because by making payments you've accepted the responsibility of the debt. If you got turned over to a collections agency, first step is to despute the charges. When you legally file for this dispute, your credit is unaffected because it's not proven (this information is coming from a recent convo I had with one of our collections agents). While it is being disputed get in touch with the hospital, or doctor and go through these steps above to try get that knocked down, because that doesn't seem right. HOpe this helps.

[dollyjn]

Thank you for the indepth! Awesome